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Blast-related traumatic brain injury. [Review]

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Citation: Lancet Neurology. 12(9):882-93, 2013 Sep.PMID: 23884075Institution: MedStar Washington Hospital CenterDepartment: RadiologyForm of publication: Journal ArticleMedline article type(s): Journal Article | ReviewSubject headings: *Blast Injuries | *Brain Injuries | *Post-Concussion Syndrome | *Stress Disorders, Post-Traumatic | Blast Injuries/ep [Epidemiology] | Blast Injuries/pp [Physiopathology] | Blast Injuries/th [Therapy] | Brain Injuries/ep [Epidemiology] | Brain Injuries/pp [Physiopathology] | Brain Injuries/th [Therapy] | Humans | Post-Concussion Syndrome/ep [Epidemiology] | Post-Concussion Syndrome/pp [Physiopathology] | Post-Concussion Syndrome/th [Therapy] | Stress Disorders, Post-Traumatic/ep [Epidemiology] | Stress Disorders, Post-Traumatic/pp [Physiopathology] | Stress Disorders, Post-Traumatic/th [Therapy]Year: 2013 Local holdings: Available online through MWHC library: May 2002 - presentISSN:

1474-4422

Abstract: A bomb blast may cause the full severity range of traumatic brain injury (TBI), from mild concussion to severe, penetrating injury. The pathophysiology of blast-related TBI is distinctive, with injury magnitude dependent on several factors, including blast energy and distance from the blast epicentre. The prevalence of blast-related mild TBI in modern war zones has varied widely, but detection is optimised by battlefield assessment of concussion and follow-up screening of all personnel with potential concussive events. There is substantial overlap between post-concussive syndrome and post-traumatic stress disorder, and blast-related mild TBI seems to increase the risk of post-traumatic stress disorder. Post-concussive syndrome, post-traumatic stress disorder, and chronic pain are a clinical triad in this patient group. Persistent impairment after blast-related mild TBI might be largely attributable to psychological factors, although a causative link between repeated mild TBIs caused by blasts and chronic traumatic encephalopathy has not been established. The application of advanced neuroimaging and the identification of specific molecular biomarkers in serum for diagnosis and prognosis are rapidly advancing, and might help to further categorise these injuries. Copyright 2013 Elsevier Ltd. All rights reserved.All authors: Armonda RA, Bragge P, Grimes JB, Ling GS, McFarlane AC, Rosenfeld JVFiscal year: FY2014Digital Object Identifier:

http://dx.doi.org/10.1016/S1474-4422(13)70161-3

Date added to catalog: 2013-12-24

Holdings ( 1 )
Title notes ( 3 )

Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	23884075	Available		23884075

Available online through MWHC library: May 2002 - present

A bomb blast may cause the full severity range of traumatic brain injury (TBI), from mild concussion to severe, penetrating injury. The pathophysiology of blast-related TBI is distinctive, with injury magnitude dependent on several factors, including blast energy and distance from the blast epicentre. The prevalence of blast-related mild TBI in modern war zones has varied widely, but detection is optimised by battlefield assessment of concussion and follow-up screening of all personnel with potential concussive events. There is substantial overlap between post-concussive syndrome and post-traumatic stress disorder, and blast-related mild TBI seems to increase the risk of post-traumatic stress disorder. Post-concussive syndrome, post-traumatic stress disorder, and chronic pain are a clinical triad in this patient group. Persistent impairment after blast-related mild TBI might be largely attributable to psychological factors, although a causative link between repeated mild TBIs caused by blasts and chronic traumatic encephalopathy has not been established. The application of advanced neuroimaging and the identification of specific molecular biomarkers in serum for diagnosis and prognosis are rapidly advancing, and might help to further categorise these injuries. Copyright 2013 Elsevier Ltd. All rights reserved.

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